Sandersfuttrup8179

jury help to identify social-health risks of sustaining a head, neck, or brain injury. These racial disparities between black and white adolescents seen at the ED for head, neck, or brain injury suggest the need for further research to better understand the national representation of these disparities.

Spinal injuries (SIs) can pose a significant burden to patients and family; delayed surgical intervention, associated with interhospital transfer, results in worse outcomes.

This study aimed to identify early patient-centered factors associated with risk for near-shore SIs to assist clinicians with expeditious medical decision-making.

We performed a multicenter retrospective study of all adults transported from Ocean City, Maryland to two emergency departments (EDs) and one regional trauma center for evaluation of suspected SIs from 2006 to 2017. Outcomes were any SI and any spinal cord injury (SCI). Multivariable logistic regression was performed for association of environmental and clinical factors with outcomes.

We analyzed 278 records, 102 patients (37%) were diagnosed with any SI and 41 (15%) were diagnosed with SCIs. Compared with patients without SI, patients with SI were more likely to be older (48 vs. 39years), male (90% vs. 70%), with pre-existing spinal condition (62% vs. 33%), and injury caused by diving (11% vs. 2%). Multivariable logistic regression showed age (odd ratio [OR] 1.07; 95% confidence interval [CI] 1.04-1.11), diving (OR 3.5; 95% CI 3-100+), and wave height (OR 4.5; 95% CI 1.35-15.2) were associated with any SI, and a chief complaint of extremity numbness or tingling (OR 5.73; 95% CI 1.2-27.9) was associated with SCI.

We identified older age, diving, and higher wave height as risk factors for any SI and symptoms of numbness and tingling were associated with SCIs. CPI-455 molecular weight Clinicians should consider expediting these patients' transfers to a trauma center with neurosurgical capability.

We identified older age, diving, and higher wave height as risk factors for any SI and symptoms of numbness and tingling were associated with SCIs. Clinicians should consider expediting these patients' transfers to a trauma center with neurosurgical capability.

An atrio-esophageal fistula is an exceedingly rare but devastating complication of atrial fibrillation (AF) ablation procedures. Delays to diagnosis and definitive treatment herald a poor prognosis, with the development of catastrophic neurological injury or death secondary to cerebral air emboli. A high level of suspicion is essential to improve recognition of this rare but devastating condition.

A 59-year-old man presented to the emergency department with an acute stroke and reduced consciousness. This presentation was preceded by an uncomplicated AF ablation 19days prior and a subsequent emergency department attendance within a few days of his procedure, where he had presented with a history of new chest pain and reflux symptoms. Imaging revealed intra-cranial and intra-cardiac air, which was attributed to an uncontrolled atrio-esophageal fistula. Treatment options were limited by the patient's clinical instability and the patient was eventually palliated after developing catastrophic brain injury due iated after developing catastrophic brain injury due to extensive cerebral air emboli. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? Patients typically first present to the emergency department with new symptoms of either gastroesophageal reflux or chest pain, therefore, early recognition by emergency physicians is vital. Characteristic symptoms alongside a recent history of a cardiac ablation procedure should prompt additional diagnostic imaging to look for evidence of an atrio-esophageal fistula.

The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward.

To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic.

A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families.

Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients' mental health and accessare. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care.

The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.

The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.

Two-stage exchange using antibiotic-loaded spacers is a common approach in treating periprosthetic joint infections. Acute kidney injury (AKIN) can be a systemic complication of this procedure. This study investigates the prevalence of AKIN and identifies potential risk factors.

This is a single-center retrospective analysis of patients undergoing 2-stage exchange using a spacer in 285 patients treated between 2010 and 2017. Risk factors were evaluated using parametric and nonparametric analyses and a multivariate, binary logistic regression model.

Thirty-three percent of patients (95/285) developed an AKIN postoperatively. Twenty-four percent (23/95) of these patients had an acute on chronic kidney failure with a previously impaired renal function. In multivariate analysis, a higher age (hazard ratio [HR], 1.034; 95% confidence interval [CI], 1-1.068; P= .046) and a higher baseline creatinine level (HR, 1.94; 95% CI, 1.237-3.052; P= .004) were risk factors for AKIN. Treatment with vancomycin in the spacer or systemically was not associated with AKIN while a high vancomycin blood level (HR, 1.